Individual
BRIAN WIENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, SCD
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0639
SD
2251X0800X
Orthopedic Physical Therapist
0639
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316195209
WELLMARK BCBS/TRICARE
—
01
—
9296204
DAKOTACARE
—
Enumeration date
09/04/2008
Last updated
10/05/2016
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